Neuromuscular electrophonopedic stimulation of the larynx after surgical treatment of patients with differentiated thyroid cancer

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Abstract

BACKGROUND: Thyroid cancer is the most common endocrine malignancy, accounting for 3.4% of all cancers diagnosed annually. Differentiated thyroid cancer (DTC) is primarily treated with surgery, which can often involve complications such as postoperative pareses or reversible laryngeal nerve (RLN) paralysis. Currently, rehabilitation possibilities for patients with postoperative RLN pairs are relevant. In this study, we used neuromuscular electrostimulation with vocaSTIM in combination with drug therapy and evaluated the effectiveness of the rehabilitation.

AIMS: To determine the possibility of using neuromuscular electrophonopathic laryngeal stimulation (NMELS) in restoring laryngeal function after surgical treatment of DTC complicated by pareses/paralysis of thr RLN.

MATERIALS AND METHODS: Seventy-six patients with DTC who have undergone surgical treatment, complicated by paresis of RLN, were enrolled in this study.

RESULTS: The study analyzed the treatment results of these 76 patients. The age of the patients ranged from 6 to 78 (average age, 47) years, the female-to-male ratio was 59 to 17 (women, 77.6%; men, 22.4%). Postoperative unilateral laryngeal paresis was present in 56 patients (73.68%) and bilateral lesions in 20 (26.32%). Phonation violation was found in all patients: dysphonia, 76 (100%); dysphagia, 28 (36.84%); and respiratory failure, 11 (14.47%), and 2 patients (2.63%) were tracheotomized postoperatively. All patients underwent neuro-phonic rehabilitation with mandatory assessment and video fixation of laryngeal function. As a result of neuromuscular electrophonopathic stimulation of the larynx, 69 out of 76 patients (90.79%) had improved larynx function.

CONCLUSIONS: Based on our experience, NMELS with vocaSTIM can be used for restoring the functions of the larynx in patients with RLN paresis of varying severities, after surgical treatment for DTC.

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About the authors

Eduard O. Vyazmenov

Endocrinology Research Centre; N.I. Pirogov Russian National Research Medical University

Email: hnodoctor@gmail.com
ORCID iD: 0000-0002-2880-4882
SPIN-code: 4838-5368

MD, Cand. Sci. (Med.), associate professor

Russian Federation, 11 Dmitry Ulyanov street, 117292 Moscow; Moscow

Mikhail M. Polunin

N.I. Pirogov Russian National Research Medical University

Email: mmpolunin@gmail.com
ORCID iD: 0000-0002-9086-726X
SPIN-code: 1199-4723

MD, Dr. Sci. (Med.), professor

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Konstantin Y. Slashchuk

Endocrinology Research Centre

Email: slashuk911@gmail.com
ORCID iD: 0000-0002-3220-2438
SPIN-code: 3079-8033

MD, Cand. Sci. (Med.), research associate

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Dmitry G. Beltsevich

Endocrinology Research Center

Email: belts67@gmail.com
ORCID iD: 0000-0001-7098-4584
SPIN-code: 4475-6327

MD, Dr. Sci. (Med.), chief research associate

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Ilana A. Katsobashvili

Endocrinology Research Center

Email: kacobashvili.ilana@mail.ru
ORCID iD: 0000-0002-4388-6097
SPIN-code: 7274-3990

resident

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Julia V. Shotik

Endocrinology Research Center

Email: vika281095@mail.ru
ORCID iD: 0000-0001-9678-5794

resident

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Daria G. Sardaeva

Endocrinology Research Center

Email: sardaieva96@mail.ru
ORCID iD: 0000-0001-9418-1786

resident

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

Nataliya G. Mokrysheva

Endocrinology Research Center

Author for correspondence.
Email: mokrisheva.natalia@endocrincentr.ru
ORCID iD: 0000-0002-9717-9742
SPIN-code: 5624-3875

MD, Dr. Sci. (Med.), professor, member of Russian Academy of Sciences

Russian Federation, 11 Dmitry Ulyanov street, 117292, Moscow

References

  1. Prete A, Borges de Souza P, Censi S, et al. Update on fundamental mechanisms of thyroid cancer. Front Endocrinol. 2020:11:102. doi: 10.3389/fendo.2020.00102
  2. Stewart LA, Kuo JH. Advancements in the treatment of differentiated thyroid cancer. Ther Adv Endocrinol Metab. 2021;12: 20420188211000251. doi: 10.1177/20420188211000251
  3. Luster M, Clarke SE, Dietlein M, et al. Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging. 2008;35(10):1941–1959. doi: 10.1007/s00259-008-0883-1
  4. Medas F, Canu GL, Boi F, et al. Predictive factors of recurrence in patients with differentiated thyroid carcinoma: a retrospective analysis on 579 patients. Cancers (Basel). 2019;11(9):1230. doi: 10.3390/cancers11091230
  5. Panh J. Basis und konzeption der therapie von larynxparesen durch neuromuskulare elektrophonatorische stimulation (NMEPS). Kurze einfmhrung in die therapie von larynxparesen, aphasie, dysphasie und dysartrie mit dem Gerltekonzept vocaSTIM. 2002. 24 p.
  6. Cirocchi R, Arezzo A, D’Andrea V, et al. Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev. 2019;1(1):CD012483. doi: 10.1002/14651858.CD012483.pub2
  7. Addasi N, Fingeret A, Goldner W. Hemithyroidectomy for thyroid cancer: a review. Medicina (Kaunas). 2020;56(11):586. doi: 10.3390/medicina56110586
  8. Barczyński M, Konturek A, Cichoń S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg. 2009;96(3):240–246. doi: 10.1002/bjs.6417
  9. Lynch J, Parameswaran R. Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: a review. Head Neck. 2017;39(7):1470–1478. doi: 10.1002/hed.24772
  10. Krasnodębska P, Domeracka-Kołodziej A, Szkiełkowska A, et al. Assessment of short-term functional voice therapy in patients with unilateral paralysis of the larynx. Otolaryngol Pol. 2018;72(2):36–34. doi: 10.5604/01.3001.0011.7250
  11. Kosztyła-Hojna B, Moskal D, Rogowski M, et al. The usage of modern physioterapeutic methods of rehabilitation in treatment of chosen kinds of dysphonia. Otolaryngol Pol. 2012;66(5):328–336. doi: 10.1016/j.otpol.2012.06.020
  12. Shelesko EV, Abdulgamidov AH, Chernikova NA, et al. Electrical stimulation for paresis of the larynx and pharynx. Literature review. Evrazijskij nauchnyj zhurnal. 2021;(7): 3–10. (In Russ).
  13. Hyman A. Resuscitation of the stopped heart in intracardial therapy. II. Experimental use of an artificial pacemaker. American Heart Journal. 1933;8(4):563–564. doi: 10.1016/s0002-87 03(33)9067
  14. Zealear DL, Rainey CL, Herzon GD, et al. Electrical pacing of the paralyzed human larynx. Ann Otol Rhinol Laryngol. 1996;105(9): 689–693. doi: 10.1177/000348949610500904
  15. Bedareva NA, Evnevich GV. The use of neuromuscular stimulation of laryngeal muscles with the vocaSTIM apparatus for the treatment of bulbar disorders. Russian journal of physiotherapy, balneology and rehabilitation. 2013;5:45–46. (In Russ).
  16. Shilenkova VV, Filatova EA, Korotchenko VV. Reabilitacija golosa u bol’nyh gipotonusnoj disfoniej metodom nejromyshechnoj jelektrofonopedicheskoj stimuljacii gortani. Rossijskaja otorinolaringologija. 2007;(2):121–125. (In Russ).
  17. Stepanova JE, Gotovyahina TV, Mokhotaeva MV, Mahotkina NN. Complex rehabilitation of patients with unilateral vocal fold paresis after thyroid surgery (medical and pedagogical recommendations). Russian otorhinolaryngology. 2014;4:131–137. (In Russ).
  18. Kryukov AI, Romanenko SG, Pavlikhin OG, Lesogorova EV. Clinical and functional state of the larynx in older patients with chronic edematous-polypous laryngitis. Bulletin of otorhinolaryngology. 2018;83(1):56–58. (In Russ). doi: 10.17116/otorino201883156-58

Supplementary files

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1. JATS XML
2. Fig. 1. Unilateral paresis of the larynx before neuromuscular stimulation with vocaSTIM.

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3. Fig. 2. Unilateral paresis of the larynx after neuromuscular stimulation with vocaSTIM.

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4. Fig. 3. Bilateral paresis of the larynx before neuromuscular stimulation with vocaSTIM.

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5. Fig. 4. Bilateral paresis of the larynx after neuromuscular stimulation with vocaSTIM.

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6. Fig. 5. Bilateral paresis of the larynx before neuromuscular stimulation with vocaSTIM.

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7. Fig. 6. Bilateral paresis of the larynx after neuromuscular stimulation with vocaSTIM.

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